Adjuvant systemic therapy in breast cancer

Systemic adjuvant therapy has improved the prognosis of patients with primary breast cancer. Meta-analyses have demonstrated that approximately one fourth of deaths can be avoided among younger women treated with multiple cytotoxic drug regimens and among older women treated with tamoxifen. However, with the treatments available today many aspects related to the optimal therapy, taking into account the physical, psychological and socioeconomic consequences, are still open. This review discusses some of the major open questions related to the effectiveness of the adjuvant systemic therapy in terms of its ability to reduce recurrence rate and mortality.